Certified Revenue Cycle Representative Certification
Exam Questions and Verified Answers 2025\2026
update
1. HFMA patient financial communications best practices call for annual train-
ing for all staff EXCEPT: A. Patient access
B. Customer service representatives
- answer C. Nursing
D. Staff who engage in patient financial communications discussions
2. What is required for the UB-04/837-I, used by Rural Health Clinics to gener- ate
payment from Medicare?: Medical necessity documentation
B. The CMS 1500 Part B attachment
C. Correct Part A and B procedural codes
- answer D. Revenue codes
3. The most common resolution methods for credit balances include all of the following
EXCEPT: A. Designate the overpayment for charity care
B. Determine the correct primary payer and notify incorrect payer of overpayment
C. Submit the corrected claim to the payer incorporating credits
D. Either send a refund or complete a takeback form as directed by the payer.
4. Net Accounts Receivable is: A. The total bad debt
B. Total debt owed by an entity
,- answer C. The amount an entity is reasonably confident of collecting from overall accounts
receivable
E. The total claims amount billed to health plans
5. For routine scenarios, such as patients with insurance coverage or a known ability to
pay, financial discussions: A. May take place between the patient and discharge planning
- answer B. Should take place between the patient or guarantor and properly trained provider
representatives
C. Are optional
D. Are focused on verifying required third-party payer information
6. Scheduled procedures routinely include: A. Physician's office contact informa- tion
B. Physician notification that scheduling is complete
C. The scheduler's name and contact information
- answer D. Patient preparation instructions
7. ICD-10-CM and ICD-10-PCS code sets are modifications of: A. DRGs
B. CPT codes
C. ICD 9 codes
- answer D. The international ICD-10 codes as developed by the WHO (World Health
Organization)
8. The Medicare Bundled Payments for Care Initiative (BCPI) is designed to: A. Prevent
duplicate billing
B. "Stretch" the impact of patient self-pay by squeezing costs down through a
, lump-sum payment to providers
- answer C. Align incentives between hospitals, physicians, and non-physician providers in
order to better coordinate patient care
D. Drive down physician fees by forcing physicians to share equitably in one payment
9. Which of the following is required for participation in Medicaid: A. Be free of chronic
conditions
B. Meet a minimum yearly premium
C. Obtain a supplemental health insurance policy
- answer D. Meet income and assets requirements
10. A four digit number code established by the National Uniform Billing Committee
(NUBC) that categorizes/classifies a line item in the charge master is known as: A. CPT
codes
B. ICD-10 Procedural codes
C. HCPCs codes
- answer D. Revenue codes
11. Checks received through mail, cash received through mail, and lock box are all
examples of: A. Payment methods being phased out for more secure payment method
option
- answer B. Control points for cash posting
C. Payment methods in which the majority of fraud occurs
D. Highly fraud prone processes
Exam Questions and Verified Answers 2025\2026
update
1. HFMA patient financial communications best practices call for annual train-
ing for all staff EXCEPT: A. Patient access
B. Customer service representatives
- answer C. Nursing
D. Staff who engage in patient financial communications discussions
2. What is required for the UB-04/837-I, used by Rural Health Clinics to gener- ate
payment from Medicare?: Medical necessity documentation
B. The CMS 1500 Part B attachment
C. Correct Part A and B procedural codes
- answer D. Revenue codes
3. The most common resolution methods for credit balances include all of the following
EXCEPT: A. Designate the overpayment for charity care
B. Determine the correct primary payer and notify incorrect payer of overpayment
C. Submit the corrected claim to the payer incorporating credits
D. Either send a refund or complete a takeback form as directed by the payer.
4. Net Accounts Receivable is: A. The total bad debt
B. Total debt owed by an entity
,- answer C. The amount an entity is reasonably confident of collecting from overall accounts
receivable
E. The total claims amount billed to health plans
5. For routine scenarios, such as patients with insurance coverage or a known ability to
pay, financial discussions: A. May take place between the patient and discharge planning
- answer B. Should take place between the patient or guarantor and properly trained provider
representatives
C. Are optional
D. Are focused on verifying required third-party payer information
6. Scheduled procedures routinely include: A. Physician's office contact informa- tion
B. Physician notification that scheduling is complete
C. The scheduler's name and contact information
- answer D. Patient preparation instructions
7. ICD-10-CM and ICD-10-PCS code sets are modifications of: A. DRGs
B. CPT codes
C. ICD 9 codes
- answer D. The international ICD-10 codes as developed by the WHO (World Health
Organization)
8. The Medicare Bundled Payments for Care Initiative (BCPI) is designed to: A. Prevent
duplicate billing
B. "Stretch" the impact of patient self-pay by squeezing costs down through a
, lump-sum payment to providers
- answer C. Align incentives between hospitals, physicians, and non-physician providers in
order to better coordinate patient care
D. Drive down physician fees by forcing physicians to share equitably in one payment
9. Which of the following is required for participation in Medicaid: A. Be free of chronic
conditions
B. Meet a minimum yearly premium
C. Obtain a supplemental health insurance policy
- answer D. Meet income and assets requirements
10. A four digit number code established by the National Uniform Billing Committee
(NUBC) that categorizes/classifies a line item in the charge master is known as: A. CPT
codes
B. ICD-10 Procedural codes
C. HCPCs codes
- answer D. Revenue codes
11. Checks received through mail, cash received through mail, and lock box are all
examples of: A. Payment methods being phased out for more secure payment method
option
- answer B. Control points for cash posting
C. Payment methods in which the majority of fraud occurs
D. Highly fraud prone processes
